Wound Healing Of Pressure Ulcers Research Articles

Effectiveness of glutamine and arginine in wound healing of pressure ulcers: A systematic review protocol

IntroductionVarious nutrients play a physiological role in the healing process of pressure ulcers (PUs). Nutritional interventions include the administration of enteral nutritional supplements and formulas containing arginine, glutamine, and micronutrients. The aim of this systematic review is to evaluate the effectiveness of enteral nutritional supplements and formulas containing arginine and glutamine on wound-related outcomes. These include (1) time to healing, (2) changes in wound size, (3) local wound infection, (4) PU recurrence, and (5) PU-related pain. Materials and methodsThis protocol was developed according to the guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). A search will be conducted in the Cochrane Library, EMBASE, PubMed (MEDLINE), CINAHL (EBSCOhost interface) and Web of Science. In addition, a manual search will be conducted to identify relevant records. Except for systematic reviews, no restrictions will be placed on the study design, the population studied or the setting. Studies that do not address PUs, in vitro studies and studies that do not report wound-related outcomes will be excluded. Study selection, risk of bias assessment and data extraction will be performed independently by three researchers. Depending on the extent of heterogeneity of interventions, follow-up time and populations, results will be summarised either by meta-analysis or narrative synthesis. ConclusionsThis is the first systematic review to identify, evaluate and summarise the current evidence for enteral arginine and glutamine supplementation on wound-related outcomes in PUs. The review will provide a solid basis for deriving valid and clinically relevant conclusions in this area.

The effect of high-voltage monophasic pulsed current on diabetic ulcers and their potential pathophysiologic factors: A systematic review and meta-analysis.

The present review was conducted to determine the efficacy of high-voltage monophasic pulsed current (HVMPC) in treating diabetic ulcers, assess its effect on skin lesions with each of the pathophysiologic factors potentially contributing to diabetic ulcers, evaluate its safety, and identify treatment parameters. Electronic search of PubMed, Scopus, PEDro and Google Scholar databases was conducted. The revised tool for assessing risk of bias in randomised trials (RoB 2), the risk of bias in non-randomised studies-of interventions (ROBINS-I) and the Joanna Briggs Institute (JBI) critical appraisal tool were used to assess risk of bias and methodological quality. Overall quality of evidence was determined using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) principles. Thirty-two studies matched the eligibility criteria, and included 1061 patients with 1103 skin lesions of selected aetiologies; 12 randomised controlled trials were included in quantitative synthesis. HVMPC plus standard wound care (SWC) likely increased the probability of complete wound healing of pressure ulcers (PrUs) compared with sham/no stimulation plus SWC; relative risk (RR) 2.08; 95% CI: [1.42, 3.04], p= 0.0002; I2 = 0%, p= 0.61; eight studies, 358 ulcers. Although conclusive evidence regarding the effect of HVMPC on diabetic ulcers was not found, collateral evidence might suggest a potential benefit. Direct evidence, with moderate certainty, may support its efficacy in treating PrUs, albeit few adverse reactions were reported. Other observations, moreover, might indicate that this efficacy may not be limited to PrUs. Nonetheless, several aspects remain to be clarified for safe and effective application of electrical stimulation for wound healing.

Literature review: The effect of honey in pressure ulcer wound healing acceleration

Background: Pressure ulcers occur due to prolonged pressure and friction in areas of bony prominences that result in tissue injury with varying depths. To date, there is no standardized wound dressing for these ulcers. From the review of the availability and affordability aspects, honey can be used as a wound dressing because it contains anti-oxidants, anti-inflammatory, and anti-bacterial properties. This article investigates the advantages of honey dressing over other modern dressings. Methods: Literature search from online databases using relevant keywords. A total of three articles were discussed in this review article. Results: All articles agreed that giving honey to pressure ulcer wounds reduced wound size and pain. Honey-soaked gauze provided quicker pain relief during treatment and reduced discomfort with each dressing change. Wound healing was proven to be four times faster with honey compared to other topical dressings. The anti-bacterial effect of honey could not be significantly confirmed in this study. Nonetheless, honey dressings succeeded in accelerating wound healing in patients with pressure ulcers. Conclusion: Honey can be a promising alternative to topical dressings in patients with pressure ulcers.

788 Baicalin accelerates wound healing in a murine model of ischemic pressure ulcer lesions

Pressure ulcers are a common skin disease that affects the elderly and patients with perceptual or mobility disorders. A pressure ulcer is an ischemic skin necrosis or ulcer that occurs when pressure is applied to a region of the body for an extended period of time, producing poor blood circulation and a lack of oxygen and nutrients. Natural origin pharmaceuticals account for more than half of all modern drugs, and they play an essential role in drug development programs. Baicalin is one of the most important flavonoids in plants, and it is responsible for their pharmacologic effects. This type of natural ingredients provide a wide range of pharmacologic benefits, including anti-inflammatory and anti-tumor properties. The two key processes linked with wound development and effecting the wound healing process with baicalin antioxidant in treating pressure ulcers are oxidative stress and inflammation. However, the effect of baicalin on wound healing in pressure ulcers has not been thoroughly investigated. The wound healing efficacy of baicalin in treating pressure ulcers in a murine pressure ulcer model is investigated in this study. First, the development of 1, 2, 3, 4 stage pressure ulcers after ischemia-reperfusion(I/R) cycle in a murine mouse model. In this model, we investigated the effectiveness of a baicalin in the wound healing of pressure ulcers. We found that baicalin promotes granulation tissue formation, accelerated wound closure, reduced proinflammatory cytokines production and inducing the differentiation of keratinocytes were observed. We expect that this study will contribute to the potential wound therapeutic agent for a pressure ulcer patient.

Evaluation of an educational film as a learning tool for nurses caring for seniors with pressure ulcers

Background: Pressure ulcers last to be a severe and prevalent health condition in hospitals; they have been considered the most physically debilitating and expensive problems of the twentieth century. Advanced pressure ulcers are common in the elderly; about 70% happen in cases 65 years or older, peaking range from 70 and 80. Many pressure ulcers are considered preventable or even treatable with the proper procedures to preserve skin integrity. Objectives: This work aims to evaluate the influence of an instructional film on nurses caring for seniors with pressure ulcers in terms of attitude and knowledge. Materials and Method. The research employed a quasi-experimental design and was conducted in intensive care Units of the General Mansoura Hospital, Specialized Medical Hospital, and Emergency Hospital in Dakhalia governorate. The research surveyed 69 nurses. Two instruments were utilized in this research: the Braden Scale and a two-part structured interview schedule sheet. Results: Following the educational film, the nurse's practice and knowledge increased, plus there was an enhancement in wound healing of pressure ulcers for older adults. Conclusion: This study concluded that nurses' knowledge and attitude have improved after displaying the educational film program.

Effect of Chinese herbal topical medicine, acupuncture, and moxibustion on pressure ulcer wound healing: A meta-analysis.

We performed a meta-analysis to evaluate the effect of Chinese herbal topical medicine, acupuncture, and moxibustion on pressure ulcer wound healing. A systematic literature search up to January 2022 was done and 13 studies included 1073 subjects with pressure ulcer wound at the start of the study; 593 of them were using traditional Chinese medicine treatments, and 480 were control for pressure ulcer wound. We calculated the odds ratio (OR) with 95% confidence intervals (CIs) to evaluate the effect of Chinese herbal topical medicine, acupuncture, and moxibustion on pressure ulcer wound healing by the dichotomous methods with a random or fixed-influence model. Traditional Chinese medicine treatments had significantly higher complete healing (OR, 5.94; 95% CI, 3.94-8.95, P < .001), and curative ratio post-treatment (OR, 4.79; 95% CI, 2.62-8.76, P < .001) compared with control for subjects with pressure ulcer wound. Traditional Chinese medicine treatments had a significantly higher complete healing and curative ratio post-treatment compared with control for subjects with pressure ulcer wounds. Further studies are needed to validate these findings.

Higher Periwound Temperature Associated with Wound Healing of Pressure Ulcers Detected by Infrared Thermography.

Visual and empirical assessments do not enable the early detection of wound deterioration or necroses. No suitable objective indicator for predicting poor wound-healing is currently available. We used infrared thermography to determine the association between wound temperature and pressure-wound healing. We examined patients with grades 2–4 pressure ulcers from a medical center in southern Taiwan and recorded the temperatures of the wound bed, periwound, and normal skin using infrared thermographic cameras. A total of 50 pressure ulcers and 248 infrared-thermography temperature records were analyzed. Normal skin temperature was not related to pressure ulcer wound healing. In a multivariate analysis, higher malnutrition universal-screening-tool scores were associated with poor wound-healing (p = 0.020), and higher periwound-temperature values were associated with better wound-healing (p = 0.028). In patients who had higher periwound-skin temperature than that of the wound bed, that result was also associated with better wound-healing (p = 0.002). Wound-bed and periwound temperatures differed significantly with the grade of the pressure ulcer, and a high periwound temperature was positively correlated with wound healing. Infrared thermography can objectively serve as indicators for assessing pressure-ulcer healing.

Histological and clinical evaluation of wound healing in pressure ulcers: a novel animal model

Pressure ulcers (PUs) are a major healthcare problem, commonly associated with older people, patients who are bedbound and patients with diabetes. The impact of PUs can decrease patients' quality of life, and lead to high morbidity and mortality rates. In this study, we aimed to describe a novel PU model that simulates pressure ulcers in humans to provide a research tool for new drug testing. Diabetes was induced using streptozocin in 75 adult Sprague Dawley rats. To create the PU, skin was sandwiched between two magnets, one of them implanted below the panniculus carnosus muscle and the other above the skin. The model was tested on nondiabetic rats and diabetic rats, each with pressure ulcers, compared to nondiabetic rats with excisional wounds. Results showed that the PU model in diabetic (p-value<0.000001) and non-diabetic rats (p-value<0.05) exhibited significantly delayed healing (no healing over 21 days) compared with the excisional wound that was completely healed by day 21. Diabetic rats showed significant changes in intact skin compared with non-diabetic rats, as well as a significant delay in the healing process compared with the non-diabetic group. By effectively impairing the skin contraction otherwise seen in the rats, and thereby delaying healing and making it similar to that seen in hard-to-heal PUs in humans, this model provides an effective tool for wound healing research.

Histological and clinical evaluation of wound healing in pressure ulcers: a novel animal model.

Pressure ulcers (PUs) are a major healthcare problem, commonly associated with older people, patients who are bedbound and patients with diabetes. The impact of PUs can decrease patients' quality of life, and lead to high morbidity and mortality rates. In this study, we aimed to describe a novel PU model that simulates pressure ulcers in humans to provide a research tool for new drug testing. Diabetes was induced using streptozocin in 75 adult Sprague Dawley rats. To create the PU, skin was sandwiched between two magnets, one of them implanted below the panniculus carnosus muscle and the other above the skin. The model was tested on nondiabetic rats and diabetic rats, each with pressure ulcers, compared to nondiabetic rats with excisional wounds. Results showed that the PU model in diabetic (p-value<0.000001) and non-diabetic rats (p-value<0.05) exhibited significantly delayed healing (no healing over 21 days) compared with the excisional wound that was completely healed by day 21. Diabetic rats showed significant changes in intact skin compared with non-diabetic rats, as well as a significant delay in the healing process compared with the non-diabetic group. By effectively impairing the skin contraction otherwise seen in the rats, and thereby delaying healing and making it similar to that seen in hard-to-heal PUs in humans, this model provides an effective tool for wound healing research.

Effects of adipose-derived mesenchymal stem cells from type 2 diabetes mellitus patients on wound healing of pressure ulcers in mice

To investigate the effects of adipose-derived mesenchymal stem cells (AMSCs) from type 2 diabetes mellitus patients on wound healing of pressure ulcers in mice. Methods: (1) In September 2016, the subcutaneous adipose tissue of a 60-year-old woman with type 2 diabetes mellitus was harvested, and then AMSCs were extracted by collagenase digestion and cultured. The third passage of cells were used for subsequent experiments. The morphology of cells was observed, and their osteogenic, chondrogenic, and adipogenic differentiation abilities were identified. The expressions of cell surface markers CD90, CD105, CD73, and CD34 were detected by flow cytometer (n=3). (2) Sixteen female C57BL/6 wild-type mice aged 6-8 weeks were selected, and one pressure ulcer wound was created on each side of the spine of each mouse by pressing the skin with two magnets. The two wounds of each mouse were paired and divided into diabetic AMSCs group and negative control group, injected with 100 μL phosphate buffer solution (PBS) containing green fluorescent protein-labeled AMSCs (1×10(6) cells) and 100 μL PBS, respectively. The wound healing status of the two groups within post injection day (PID) 21 was observed, and their wound healing rates on PID 5, 13, and 17 were calculated. Three mice were sacrificed on PID 11 and 21, respectively, and tissue of three wounds was harvested from each group. The skin structure was observed by hematoxylin-eosin staining, the collagen deposition was evaluated by Masson staining, and the positive expression of CD31, i. e., the number of new blood vessels was counted by immunohistochemistry. Wound tissue samples of two groups prepared on PID 21 as above-mentioned were harvested, and the positive cell rate of S100, representing the regeneration of Schwann cells, was detected by immunohistochemistry. Wound tissue samples of diabetic AMSCs group prepared on PID 11 as above-mentioned were harvested, and the colonization of AMSCs was observed by fluorescence tracer method. Data were processed with paired t test and Bonferroni correction. Results: (1) The third passage of cells isolated and cultured from the subcutaneous adipose tissue of a type 2 diabetes mellitus patient grew adherently to the wall in a long spindle and vortex-like manner. After induction, the cells showed osteogenic, chondrogenic, and lipogenic differentiation abilities. The positive expression rates of CD90, CD105, and CD73 on the cell surface were higher than 90.00%, and the expression rate of CD34 was 0.46%. The cells were identified as AMSCs. (2) The mice wounds of diabetic AMSCs group healed quickly, and all the wounds healed completely on PID 17, while the mice wounds in negative control group were not completely closed at this time, and there was still scab on the surface. On PID 5, 13, and 17, the healing rates of mice wounds of diabetic AMSCs group were (35.6±6.5)%, (87.1±2.5)%, and 100.0%, respectively, significantly higher than (19.8±7.2)%, (66.2±5.2)%, and (86.9±5.3)% of negative control group (t=6.49, 14.31, 9.73, P<0.05). Compared with that of negative control group, the inflammatory cell infiltration was reduced in mice wounds tissue of diabetic AMSCs group on PID 11, and thicker epidermis and dermis as well as regenerated skin appendages were observed on PID 21. On PID 11 and 21, the collagen percentages of mice wounds tissue in diabetic AMSCs group was (48.3±1.3)% and (54.1±1.7)%, respectively, significantly higher than (41.4±1.7)% and (50.3±1.2)% of negative control group (t=6.98, 3.99, P<0.01). On PID 11 and 21, the numbers of new blood vessels in mice wounds tissue of diabetic AMSCs group were 17.2±1.3 and 18.0±2.1, respectively, significantly more than 8.0±1.4 and 14.0±1.5 of negative control group (t=10.69, 3.38, P<0.01). On PID 21, the S100 positive cell percentage in mice wounds tissue of diabetic AMSCs group was (1.76±0.12)%, significantly higher than (0.55±0.03)% of negative control group (t=21.68, P<0.001). On PID 11, the colonization of AMSCs in mice wounds tissue of diabetic AMSCs group was observed. Conclusions: Transplantation of AMSCs from type 2 diabetic mellitus patients can accelerate wound healing of pressure ulcers in mice by promoting angiogenesis, collagen deposition, and Schwann cell regeneration.

Caffeic acid phenethyl ester promotes wound healing of mice pressure ulcers affecting NF-κB, NOS2 and NRF2 expression

AimsIn pressure ulcers, the synthesis of reactive oxygen species induced by ischemia and reperfusion leads to chronic inflammation and tissue damage, which impair the closure of these lesions. Caffeic acid phenethyl ester (CAPE), found in propolis, promotes cutaneous wound healing of acute lesions and severe burns. However, the effects of CAPE on wound healing of pressure ulcers have not been investigated. This study investigated the effects of CAPE administration in a murine model of pressure ulcers. Main methodsTo induce pressure ulcers, two cycles of ischemia and reperfusion by external application of two magnetic plates were performed in the skin dorsum of mice. After the last cycle, animals were treated daily with CAPE or vehicle until they were euthanized. Key findingsThe nitric oxide synthesis, lipid peroxidation, macrophage migration, protein nuclear factor kappa B and nitric-oxide synthase-2 expression were increased 3 days after ulceration but decreased 7 days later, in pressure ulcers of the CAPE group compared to that of the control group. CAPE reduced the protein expression of nuclear factor-erythroid2-related factor 2 in pressure ulcers 3 days after ulceration, but increased 7 days later. Myofibroblast density was increased in the CAPE group 7 days after ulceration, but reduced 12 days later when compared to control group. In addition, CAPE promoted collagen deposition, re-epithelialization and wound closure of mice pressure ulcers 12 days after ulceration. SignificanceCAPE brings forward inflammatory response and oxidative damage involved in injury by ischemia and reperfusion, promoting dermal reconstruction and closure of pressure ulcers.

Suppression of LRRC19 promotes cutaneous wound healing in pressure ulcers in mice

ABSTRACTThe ischemia-reperfusion (I/R) induced skin lesion has been identified as primary cause of pressure ulcer. Better understanding of the mechanism is required for new therapy development. Leucine rich repeat containing protein 19 (LRRC19) is a recently discovered transmembrane protein containing leucine-rich repeats and plays a role in immune response. To investigate the role of LRRC19 in pressure ulcers, mouse ulcer model was established with two cycles of I/R. The expression of LRRC19 was assessed during injury. siRNA mediated LRRC19 downregulation was applied to investigate the disease severity, immune cell infiltration and pro-inflammatory cytokines production. The primary skin fibroblasts were stimulated with IL-1β to dissect the molecular mechanism. LRRC19 was readily induced in I/R induced lesion site in a pattern mimicking the disease progress as measured by wound area. Knockdown of LRRC19 by siRNA significantly alleviated the disease severity and attenuated immune cell infiltration and pro-inflammatory cytokines production. In primary skin fibroblast model, siRNA knockdown of LRRC19 suppressed IL-1β mediated NFκB activation and its downstream cytokines production. LRRC19 was a novel factor for I/R-induced tissue damage by promoting NFκB dependent pro-inflammatory response. Our results supported that LRRC19 could be a potential therapeutic target for pressure ulcers.

The Impact of Stress on Pressure Ulcer Wound Healing Process and on the Psychophysiological Environment of the Individual Suffering from them.

Introduction:The occurrence of a pressure ulcer constitutes a major psychological and physiological burden and it has been linked with a reduced quality of life and increased stress of the individual.Objective:The main objective was to investigate the impact that stress has on pressure ulcer healing process and on the psychophysiological environment of the individual suffering from them.Method:The scientific literature was reviewed through Cinahl, Pub-med, EBSCO, Medline and Google scholar. The articles were chosen due to their direct correlation with the objective under study and their scientific relevance.Results:Increased stress has been demonstrated to increase the glucocorticoids levels affecting negatively the production of wound healing cytokines (IL1α, IL1β and TNFα). Matrix metalloproteases has been identified to be unregulated in occasions of increased stress in acute wounds. Stress has also been correlated with poor health behaviors that may not have a direct link on the wound healing process, although they can in part explain or enhance some of the effects of stress on wound healing.Conclusion:The correlation between stress and wound healing in acute wounds has been thoroughly investigated and its negative effects have been established. The presence of a pressure ulcer can have a detrimental impact on the stress level of an individual although further investigation is needed to establish the role of stress in chronic wounds such as pressure ulcers.

Selective inhibition of COX-2 improves cutaneous wound healing of pressure ulcers in mice through reduction of iNOS expression

AimsCyclooxygenase-2 (COX-2) and prostaglandin E2 (PGE2) are involved in chronic inflammation observed in chronic lesions. Nonetheless, neither study demonstrated if decreased COX-2 activation could promote the wound healing of pressure ulcers. Therefore, this study investigated the effect of the administration of celecoxib (a selective COX-2 inhibitor) in wound healing of pressure ulcers. Materials and methodsMale mice were treated daily with celecoxib until euthanasia. One day after the beginning of treatment, two cycles of ischemia–reperfusion by external application of two magnetic plates were performed in skin to induce pressure ulcer formation. Key findingsCelecoxib administration reduced the protein expression of inducible nitric oxide synthase (iNOS), COX-2 and PGE2. The hydroperoxide levels, neutrophil and macrophage number, and protein elastase and matrix metalloproteinase-1 levels were reduced in celecoxib-treated group when compared to control group. Celecoxib administration increased myofibroblastic differentiation, re-epithelialization and wound contraction, and decreased the skin necrosis and angiogenesis. Celecoxib administration also stimulated the formation of a more organized and mature scar increasing collagen deposition and reducing tenascin-C expression. SignificanceCelecoxib administration improves the wound healing of pressure ulcers through decreased expression of iNOS and COX-2, which reduces wound inflammation and promotes dermal reconstruction and scar formation.

Olive oil-induced reduction of oxidative damage and inflammation promotes wound healing of pressure ulcers in mice

BackgroundThe overproduction of reactive oxygen species (ROS) and exacerbated inflammatory response are the main events that impair healing of pressure ulcers. Therefore, olive oil may be a good alternative to improve the healing of these chronic lesions due to its anti-inflammatory and antioxidant properties. ObjectiveThis study investigated the effect of olive oil administration on wound healing of pressure ulcers in mice. MethodsMale Swiss mice were daily treated with olive oil or water until euthanasia. One day after the beginning of treatment, two cycles of ischemia-reperfusion by external application of two magnetic plates were performed in skin to induced pressure ulcer formation. ResultsThe olive oil administration accelerated ROS and nitric oxide (NO) synthesis and reduced oxidative damage in proteins and lipids when compared to water group. The inflammatory cell infiltration, gene tumor necrosis factor-α (TNF-α) expression and protein neutrophil elastase expression were reduced by olive oil administration when compared to water group. The re-epithelialization and blood vessel number were higher in the olive oil group than in the water group. The olive oil administration accelerated protein expression of TNF-α, active transforming growth factor-β1 and vascular endothelial growth factor-A when compared to water group. The collagen deposition, myofibroblastic differentiation and wound contraction were accelerated by olive oil administration when compared to water group. ConclusionOlive oil administration improves cutaneous wound healing of pressure ulcers in mice through the acceleration of the ROS and NO synthesis, which reduces oxidative damage and inflammation and promotes dermal reconstruction and wound closure.

Olive Oil Administration Improves Cutaneous Wound Healing of Pressure Ulcers in Mice

Chronic lesions, as pressure ulcers, present high levels of reactive oxygen species (ROS) and exacerbate inflammatory response, which impair cutaneous wound healing. Olive oil has anti‐inflammatory and antioxidant proprieties and its administration in chronically stressed mice may improve the cutaneous wound healing. The aim of this study was to investigate the effects of olive oil administration on cutaneous wound healing of pressure ulcers in mice. For this, male mice were daily treated with olive oil (1.5 g/kg) until euthanasia. One day after the beginning of treatment, two cycles of ischemia–reperfusion by external application of two magnetic plates were performed in skin to induce pressure ulcer formation. All experimental animal work was approved by the Ethical Committee for Animal Use of State University of Rio de Janeiro (CEUA/044/2014). The olive oil administration increased the wound contraction 7 days after ulceration when compared to control (water‐treated) group. The re‐epithelialization was increased by olive oil administration when compared to control group 7 and 14 days after ulceration. The ROS levels on wound area was increased 3 days after ulceration, but decreased 7 days, in olive oil‐treated group when compared to control group. The olive oil administration reduced the levels of lipid hydroperoxides when compared to control group. In conclusion, the administration of olive oil accelerates ROS synthesis and wound closure of pressure ulcer in mice.Support or Funding InformationFinancial support: Carlos Chagas Filho Foundation for Research Support in the State of Rio de Janeiro (FAPERJ).

Nano-silver active carbon fiber dressings improving bedsore wound healing in rats

Objective To study the effect of nano-silver active carbon fiber dressings on wound healing in bedsore wound animal models.Methods Adult SD rats were used and bedsore wound models were made on their back;the animals were then randomly divided into 5groups(n=10)according to different materials of the wound dressing and treatment.Groups were treated with nano-silver active carbon dressings,nano-silver dressings,active carbon dressings,Vaseline chlorhexidine dressings,or blank control.The wound healing situation,contents of angiogenic factors and inflammatory factors in wound tissues were compared among the 5groups.Results Wound healing time and the healing rates were different among the 5groups,with the healing time of rats in nano-silver active carbon dressing group being significantly shorter than those in the other 4groups(P0.05).On the 3rd,7th,14 th and 21 st days after bedsore wound modeling,the healing rates of nano-silver active carbon dressing group were significantly higher than those of the other 4groups(P0.05).The levels of angiogenesis factors and inflammatory factors were different in wound tissues of five groups,with the contents of VEGFA,VEGFB and VEGFC mRNA in nano-silver active carbon dressing group being significantly higher and the contents of TNF-α,IL-2and IL-8mRNA being significantly lower than those of the other 4groups(P0.05).Conclusion The prepared nano-silver active carbon fiber dressing can help to improve pressure ulcer wound healing,relieve wound inflammation,and promote angiogenesis in the wound;it may serve as an ideal material for treating bedsore wound.

Propranolol impairs the closure of pressure ulcers in mice

Aimsβ-Adrenoceptors modulate acute wound healing; however, few studies have shown the effects of β-adrenoceptor blockade on chronic wounds. Therefore, this study investigated the effect of β1-/β2-adrenoceptor blockade in wound healing of pressure ulcers. Main methodsMale mice were daily treated with propranolol (β1-/β2-adrenoceptor antagonist) until euthanasia. One day after the beginning of treatment, two cycles of ischemia–reperfusion by external application of two magnetic plates were performed in skin to induce pressure ulcer formation. Key findingsPropranolol administration reduced keratinocyte migration, transforming growth factor-β protein expression, re-epithelialization, and necrotic tissue loss. Neutrophil number and neutrophil elastase protein expression were increased in propranolol-treated group when compared with control group. Propranolol administration delayed macrophage mobilization and metalloproteinase-12 protein expression and reduced monocyte chemoattractant protein-1 protein expression. Myofibroblastic differentiation, angiogenesis, and wound closure were delayed in the propranolol-treated animals. Propranolol administration increased neo-epidermis thickness, reduced collagen deposition, and enhanced tenascin-C expression resulting in the formation of an immature and disorganized collagenous scar. Significanceβ1-/β2-Adrenoceptor blockade delays wound healing of ischemia–reperfusion skin injury through the impairment of the re-epithelialization and necrotic tissue loss which compromise wound inflammation, dermal reconstruction, and scar formation.

A Case of Electroacupuncture Therapy for Pressure Ulcer

Pressure ulcers (also known as bedsores or decubitus ulcers) are areas of localised injury to the skin and underlying tissue usually over a bony prominence, as a result of pressure, or pressure in combination with shear forces. This type of ulcer is one of the most common complications in patients with spinal cord injury. Treatment with transcutaneous electrical stimulation, and with acupuncture combined with moxibustion, have been reported to be effective for pressure ulcers.1 ,2 The use of electroacupuncture (EA) specifically for pressure ulcers has not been reported.3 Here, we report a case of the successful use of EA to promote wound healing of pressure ulcers. A 42-year-old woman was admitted to our acupuncture department with a …

Effects of a Comprehensive Nutritional Program on Pressure Ulcer Healing, Length of Hospital Stay, and Charges to Patients

The burden of pressure ulcers will intensify because of a rapidly increasing elderly population. The aim of this study was to examine the effects of a comprehensive, interdisciplinary nutritional protocol on pressure ulcer wound healing, length of hospital stays, and charges for pressure ulcer management. The pre/post quasi-experimental design study comprised of 100 patients (50 patients in each group) 60 years or older with pressure ulcer. Research questions were analyzed using descriptive statistics, frequencies, chi-square tests, and t tests. Study findings indicate that the intervention was effective in improving pressure ulcer wound healing, decreasing both hospital length of stay (LOS) for treatment of pressure ulcer and total hospital LOS, while showing no significant additional charges for treatment of pressure ulcers. The older adults are at the highest risk of developing pressure ulcers that result in prolonged hospitalization, high health care costs, increased mortality, and decreased quality of life.